| NPI | 1255778239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60494165) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60376336) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2015-02-25 |